Global Health at a Breaking Point: Urgent Action Beyond the Summit
On the 21st of November 2025, the Global Fund Partnership convened for the Global Fund’s 8th Replenishment Summit to save 23 million more lives and raised US$11.34 billion. The co-hosts’ call, (South Africa and the United Kingdom) for a transformative recommitment fell far short of what is needed, at a moment when failure is unaffordable and the stakes could not be higher.
We deeply appreciate every government, private sector partner, and organisation that pledged to the Global Fund. Every dollar pledged will change and save lives. We further acknowledge those who increased or maintained their commitments, as well as governments stepping up domestic investments despite severe fiscal pressures. These pledges represent a meaningful expression of shared responsibility.
But our gratitude does not erase reality. The consequences of this replenishment summit outcome extend far beyond HIV, tuberculosis, and malaria. Underfunding will further strain fragile health systems, weaken community responses, and destabilize countries already carrying the weight of overlapping crises. The economic and human cost of inaction will dwarf the investments required today.
This outcome reflects an uncomfortable truth: global health is not where it urgently needs to be on the political agenda. This shortfall will not only stall momentum, it will cost lives and we already see the Global Fund’s communication on the implications of this replenishment. Without increased support, we face the prospect of empty clinics, interrupted treatment, preventable deaths, and surges in new infections. A recent analysis suggests that cuts from European and US donors alone could result in 22.6 million deaths by 2030. This is not a projection – it is a warning of the scale of devastation that will follow if the world fails to act.
The Summit may have ended, but HIV, TB, and malaria have not, and neither can our global community’s commitment to ending them. No one is safe from disease until everyone is safe. Donors – especially those yet to pledge – must reflect on what this moment means, not only for the countries they support but also for their own economic security, health preparedness, and long-term resilience. The cost of retreat will be measured in lives lost and systems weakened. We worry that when transition is done abruptly it will mean treatment is interrupted, prevention programmes shrink, and all the while community systems are stretched beyond breaking: disease rises, and people die. The burden will fall hardest on those with the least power, the least visibility, and the most at stake.
This Replenishment Summit is not the finish line. It is one step on a much longer road. To those of you who have already pledged, we urge you to consider deepening your support. To those yet to pledge – we appeal to you to join us in this critical moment, to match that commitment with the full scale of resources and action required. This is a moment that demands courage. The world cannot afford to look away. Millions of lives depend on all of us. The resources not mobilised today must be mobilised tomorrow.
Thanks to the Partnership, the Global Fund’s progress has been driven by people (governments, civil society, community leaders, frontline health care workers, technical partners and beneficiaries) working together to keep systems moving forward. The values of courage, collaboration, and continuity have carried the Partnership through its most challenging moments, and these same values will be essential to ending the three diseases.
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